Testicular cancer: A guide to self examination

By DR MUKUHI NG’ANG’A

 

November is male cancer awareness month. Its dedicated mainly to prostrate and testicular cancers, the two which most affect men.

Its being popularised, globally, with an awareness campaign known as ‘Movember’. The spirit of Movember is to have men grow moustaches during the month as part of raising awareness about the cancers that affect men.

The awareness campaigns will end with a fundraiser event towards male cancer. Movember has yet to gain popularity in Kenya but it is well known in Europe, Australia, US and South Africa.

In the spirit of Movember we will tackle testicle and prostate cancer this month and what every man needs to know about these two male cancers.

TESTICULAR CANCER

What is normal? The testes should slide easily between your fingers. You shouldn’t feel any pain when doing the exam. One side of the scrotum hangs slightly lower than the other.

What is not normal? Pain in the testes or scrotum during the examination; One side of the scrotum appearing significantly larger than the other; Lumps on the testicle or epididymis (please note, not all of them are cancerous); An enlarged testicle; Once you get used to your normal size, any reduction in the size of one testicle is not normal (However, elderly men may notice a reduction in size of both testes – not one); Fluid collections in the scrotum; A heavy feeling in the scrotum; A dull ache in the groin or lower abdomen; and Enlargement or tenderness of the breasts.

Testicular cancer is more common in younger men, aged between 15 and 40 years, though it can occur at any age.

Risk factors:

• Undescended testes: Men whose testes have not settled down in their scrotum have a higher chance of developing testicular cancer.
• Family history: As with most cancers, if you have a family member with testicular cancer your chances of developing it are increased.
• Previous testicular cancer: If you have had cancer in one testicle you have an increased chance of developing the same in the other testicle.
• Abnormal testicle development: Boys born with testicular abnormalities have a higher chance of developing cancer.

TESTICULAR SELF-EXAM

All males above the age of 15 years should do a monthly testicular self-examination. This helps you get to know the normal structure of your body so that you can recognise changes that may signal a problem.

The self examination is best done after a warm bath or shower. This is because the heat relaxes the skin of the scrotum making it easier to handle.

Look: Stand in front of a mirror and look at your scrotum. Is one side larger than the other? Are there some unusual changes on the skin of the scrotum?

Look from the front and from the sides.

Feel: Place the index and middle fingers under the testicle and place the thumbs on top. Roll the testicle gently between the thumbs and fingers.

Examine one testicle at a time. Find the epididymis, a soft, tube-like structure behind the testicle that collects and carries sperm.

It can sometimes feel like a soft mass so get to know its normal texture.

WHAT IF YOU FIND SOMETHING AMISS?

Most men find it awkward and uncomfortable discussing their genital issues with their doctors but it is an essential part of the healthcare.

Ideally, all men should have their doctors examine their scrotum/testes at least once a year whether or not they have a problem, as part of routine physical examination.

However, if you do notice a problem during your self examination between annual check-ups go to your doctor for further care.

WHAT TO EXPECT ONCE YOU VISIT YOUR DOCTOR

Once the doctor finishes examining you, he or she may ask for some tests. These include scans and blood tests. These tests help determine whether or not you have an abnormality in your testes.

What is a biopsy?

If you have a suspicious lump in any part of your body the doctor may want to take a sample of it to take to the lab and examine under a microscope. This is known as a biopsy. This is taken using a special needle.

Are there hormonal changes?

Sometimes, you can get hormonal issues related to testicular cancer. This includes tenderness or pain in the breasts. They may also increase in size.

TREATMENT

Surgery: Usually most people have the affected testicle removed. Although most men find this a highly traumatic event – there is a positive side to this.

You can have a healthy sex life and sire children with only one testes.

Chemotherapy and Radiotherapy: This is medical treatment offered to men with testicular cancer in addition to the surgery.

Are all testicular abnormalities a sign of cancer?

No. Most testicular problems are not related to cancer. There may be infections, problems related to previous injury to the scrotum, hernias and non-cancerous fluid collections.

However, only your doctor can determine what your problem is. Testicular cancer has very good outcome with appropriate treatment and many men live a full life after dealing with it.

This article first appeared on Business Daily

My ladies and the month of October

By Kenneth Juror | Kenya  

I am sure by now you know absolutely well that October is the breast cancer awareness month. Consequently, I believe you are aware that I am a polygamous man, if you do not know then kindly revert to my previous blogs “The twins I did not of part one and two”. I am proud of my wives.

One Saturday evening I posed a question to them, my wives, on what they thought on going for a mammogram. Nicole looked up, I noticed she had not anticipated me asking such a question; Angie on the other side was quiet for a moment then said she would not go as she is scared. “I am still young and it is better not to know I have cancerous cells on my boobs than knowing”. “What will my babies do without them?” She asked.

After Nicole’s face changed she was ok with it so we planned on a day to go for the screening. I left Nicole convincing the sister on how important it was not only for the children but her own health.

Screening

A week thereafter I took them to a Nairobi hospital where we found other ladies on the queue. I felt awkward being on the queue, I was the only man, though it was not long. When it was Nicole’s turn to get in, she clutched her soft hands in mine and never wanted to let me go meanwhile on the other hand Angie clutched on it so we went in the three of us.

“Hallo Sir and ladies I will only attend to one at a time” the doctor said upon our entry

I explained to the doctor that they are my wives and that we are a family. That is why we came for check-up. The doctor smiled then welcomed us.

He talked to us through the procedure and what it all entailed basically we were being counseled. The doctor also advised Angie and Nicole to go for pap smear (cervical cancer screening).

For the latter I was required to pay some amount, I got out my medical insurance cover, the doctor told me to go to the main reception to fill in some forms and bring them to his attention.  

Before I left Nicole went in first for both the mammogram and pap smear.

Angie got hold of my hand “I am going with you” she was trembling; I was as well having the fear of the unknown and so many ifs in my mind, I had to be courageous as she may back out.

Our return

           

            We came back with the forms some I filled and left at the hospitals administration’s office. Angie held me so tightly that I could feel my bones cracking. I did not complain as I very well understood her fears as it gripped me too.

Nicole came back from the examination room then in Angie went.

The anxiety on Nicole’s eyes were quite evident as she rubbed her palms more often, something that I know she rarely does as I know her as a confident, strong woman.

The doctor gave us the results and the relief on my wife’s face was priceless I do not need to say whether it was good news or bad, the happiness was however short lived as our attention focused on the examination room’s door.

After a wait of about 15 minutes the door swung, Angie came out trembling with tears almost dropping from her eyes; she hugged me so tightly and reached for the sister. I have never fought tears the way I did that day.

Our arms were around each other’s and after a few seconds the doctor cleared his throat, we left each other but Angie sat on my lap as he gave us the results.

The doctor asked Angie “why were you trembling? What is wrong?” I interjected and told the doctor to kindly tell us what the results were and avoid sideshows. Nicole also supported my idea Angie had a different thought and went ahead to explain to the doctor why she was afraid.

All eyes on us..

            When the doctor smiled I knew all was well. “Sir your wives are free from cancerous cells on both the cervical and breast screening”. I almost threw Angie in the air save for her weight, I could not.

That was the time tears flowed and indeed they flowed. Tears of joy I must say. I had to calm my women before leaving the doctor’s office because their teary faces may scare away other ladies on the queue.

Once they were well we left, tears actually washed away all their makeup.

Nicole met her workmate on the queue, “where is he?” I greeted her and so did Angie. “He is at the car park heading back to work he just dropped me”. Nicole started seething “how come he is not with you here?” I had to pull Nicole out of the conversation and bid farewell to the friend, Purity.

I explained to Nicole that I should not be used as an SI unit of how men should treat their women as it was between two people, she was just an intruder, that meant that she was inciting Purity which was not good.

She obliged and we left. Since I had not returned the filled forms we walked hand in hand to the admin unit, Angie on my left hand and Nicole on my right. 

“Are they your wives?” a young lady asked at the office “yes of course, is there a problem” I enquired further. She answered there was nothing wrong and wished me a good day.

I noticed the shock on her face.

I noticed eyes were on us, it is as if I was singing Tupac’s all eyes on me.

I believe it is because of the women on my sides.

So far I can’t complain.

I did my part in making sure my women were ok. Angie said that by 40 we shall take you for prostrate check up. I flinched, Nicole concurred.

We were all happy it ended well though the ball was in my court.

This month could not have ended without me documenting how it went down with my two ladies.  

The twins I did not know of… Part 2

By Kenneth Juror | Kenya     

      I love Nicole with my all and as we left the hospital we went straight to our new home which was not yet over but she was head over heels on the new roof. I hastened on its construction and within a month we had moved in. We moved in earlier than anticipated so that she could get away from the eyes and mouths of many of our previous neighborhood.
Conversations in the local bar and restaurant were filled with Nicole and I. Our neighbours frowned and even smiled awkwardly at her which made her withdraw from them further.
Our new home was near basic amenities as our son walked to school thus reduced our expenses on school transport. Due to lack of a better word the best bet for a house.

Family challenges…

                  My mother-in-law came visiting to check up on her daughter, my wife, and her grandson. I indeed wanted to have another child before then we had a tête-à-tête session with my wife who was against me getting married to someone else but rather to adopt a child. It was a great idea though.
My mum in-law read my mind as her agenda was very simple “I want more grand children”
As we opened up this proverbial Pandora’s box Nicole’s father followed suit to at least talk us through the little challenge we had, during this period none of them knew whether I wanted another child or not.
The first shot was fired when my mother in-law bluntly said “take Angela to be your wife” this is Nicole’s younger sister.

I was shocked at this suggestion because in the wildest of my dreams it was unthinkable let alone doable, full pun intended. In addition, I paid for her fees while she was still in college so this is a girl whom I knew quite well. We popularly referred to her as Angie though she loved omitting "a" in her name.
Nicole was obviously not happy with the direction of suggestion and as part from being reprimanded by her own father for her “action” I took a back seat on the matter. On the second night my parents came who also weighed in on the matter

 Nicole’s departure

             My son Ricky was used to both the mother and the aunt, Angie.
There was obviously an awkward moment when Angie came in, it was awkward because she was no longer coming in as my sister-in-law but as my wife during this time my parents and my in laws all concurred that dowry was not returnable thus “remedy” was needed sooner than later.
As months grew older the awkwardness of Angie’s presence went away then one day I proposed to her we go for a short holiday in Mombasa which was actually work related but for her case since she was a job seeker she could effortlessly grab the opportunity to enjoy herself in the coastal city.      
We went then later came back. Nicole said she wanted to back to school for her second degree to which I never objected, I supported her 100%. She was nevertheless doing this so as to avoid falling into depression because as much as it was not easy on her part it was tougher on me. This is because I had to stand by the woman whom I wanted to grow old with, certainly I am still with her nonetheless her sister is also my wife which she consented to as well. I had to thus tread carefully, after all they were sisters.

             Angie was pregnant and that is when Nicole started getting panicky, agitated at the slightest conversation as it reminded her of the time she was expectant. She cried night and day.
When she woke up tears had dried on her chubby face and one could notice that indeed she was not ok. Immediately I enlisted the services of a psychologist to help in the resolution of her challenges consequently, the sister was also worried which ultimately meant that she could as well lose our unborn baby.
The doctor advised that Nicole should be away from her sister until the time she gave birth.

 A set of twins again

            Angie was doing very well during her pregnancy as she kept telling our little boy that a brother or a sister were to be “bought”. He was definitely happy because he went ahead to welcome his friends home so that one day they could see his sibling(s).
Angie called me one afternoon; it was horrible one, my hands were literally full at work. She called to inform me that she was from the clinic and that she was expecting twins; this simply uplifted me so much that I requested my boss to leave work. I headed home .

Months after this she delivered a boy and a baby girl weighing 2.2kg and 1.9kg respectively.
             She was very tired after the delivery furthermore it was a normal delivery. I was so happy because I remembered Nicole procured an abortion terminating the lives of our twins, I now have the same twins from the sister. Nicole joined us in hospital, her happiness could not be hidden, rivers of joy flowed freely this time a happy face complemented the tears.
I have never seen these sisters who are my wives this happy!
Being a polygamous man was definitely not my plan and not my choice as well but I am happy father.   

The twins I did not know of…

By Kenneth Juror | Kenya

            The good book says “He who finds a wife finds what is good and receives favor from the Lord” Proverbs 18:22, consequently in the same book in Proverbs 21:9 Better to live on a corner of the roof than share a house with a quarrelsome wife.

This is the story of my wife whom we have been married for the last four years.

            We have lived a normal life like any another couple out there making sure we always put food on the table as well as rally around to make sure all those close to us are comfortable. Between Nicole and I we were blessed with a three year old boy who always kept asking for a sister or a brother, I guess this is due to his friends who have siblings yet he does not.

            She worked as a financial advisor. This was great as we pulled resources together towards acquisition of a roof over our heads. This was part of what I had intended nonetheless I was living my dream.

All went well until she insisted on having our house in what “many” call the diaspora - Rongai. I did not object to it however she made no attempt in making sure we got a piece of land for the construction of that dream home.

Conflict of interest

            One evening I came home and informed her of a piece that I was advised of in Kitengela which indeed was within basically all the basic amenities. She vehemently repudiated the idea as she insisted that she would rather continue paying rent than move to OlKejuado municipality.

Her reasons were quite flimsy as the sole reason why she wanted us to put up in Rongai was that her friends lived there.

This got from bad to worse each day as the house became untenable for both of us either she was in as I went out and the vice versa was the order of the day. My desire to have the matter discussed was met with an enormous click that woke up the little boy each time we were to solve it.

My twins

            She started getting sickly thus took her for medical attention. She was taken in as an in-patient as she needed a keen eye of the doctor. She was in for two months each time I was being told that she had a stomach problem I was however not being told of the exact problem. After her second week the doctor called me and asked me of whether I knew what was ailing my dear wife. I knew that she was pregnant although she did not overtly tell me. So when the doctor said that she was admitted because of the after effects of an abortion she procured.I was confused, my heart sunk, angry I was trembling… “Your wife procured an abortion, were you aware she was pregnant?” I confirmed in the affirmative to the last question but perplexed at the statement.

I decided to cool off by not going in the ward to see her but rather went home.

By this time I had already bought the ¼ acre, the house plan was ready too.

            We were although communicating over the phone during her stay in hospital she was getting better each passing day. She never knew that I was told she had aborted.

I gathered courage to go to visit her.

She was shocked upon seeing me but held my cool so that she could perhaps talk of what led her to get rid of our children, what would warrant my wife to do such a thing? I asked myself.

She opened up…

                   She sat on the bed amid struggles to be up due to drugs which made her feeble, she held my hand as she explained. "I was 15 weeks pregnant when we had a fight over where we were to construct our home it became so much on me that I decided to terminate the pregnancy, they were twins". Her confession was corroborated by the gynecologist's examination report.  

I never wanted to stress her further, so I told her we could talk over it when she was out of hospital. 

The doctor finally gave me the green light after two months that she was well.

They say all that glitters is not gold, my wife made it to the statistics of married women who have procured abortion. http://www.nation.co.ke/news/-/1056/1962356/-/qbbuqs/-/index.html

The scenario was thicker when the doctor said she could no longer become pregnant as the corrosive, crude instruments used  ruptured her uterus, I was in the company of my parents in law as we were being given this best worst news. 

I am still confused   

A sequel soon...

Our unique flaws…

Here’s some good old Chinese wisdom!

 An elderly Chinese woman had two large pots, each hung on the ends of a pole, which she carried across her neck. One of the pots had a crack in it while the other pot was perfect and always delivered a full portion of water. At the end of the long walk from the stream to the house, the cracked pot arrived only half full.

                                                     (Photo courtesy)

For a full two years this went on daily, with the woman bringing home only one and a half pots of water. Of course, the perfect pot was proud of its accomplishments. But the poor cracked pot was ashamed of its own imperfection, and miserable that it could only do half of what it had been made to do.

            After 2 years of what it perceived to be bitter failure, it spoke to the woman one day by the stream. “I am ashamed of myself, because this crack in my side causes water to leak out all the way back to your house.” The old woman smiled, “Did you notice that there are flowers on your side of the path, but not on the other pot’s side? That’s because I have always known about your flaw, so I planted flower seeds on your side of the path, and every day while we walk back, you water them. For two years I have been able to pick these beautiful flowers to decorate the table. Without you being just the way you are, there would not be this beauty to grace the house.”

                                                                   (Photo courtesy)

Each of us has our own unique flaw…

But it’s the cracks and flaws we each have that make our lives together so very interesting and rewarding. You’ve just got to take each person for what they are and look for the good in them.

To all of my crackpot friends, have a great day and remember to smell the flowers, on your side of the path.

Just like the fingers are, they are not the same size, so are our friendships, relationships, marriages let us learn to live with each other harmoniously. 

Take the time to share this message to all your friends who have a cracked side…

And God knows how many we are!!!

Courtesy

Tribut : VIVIANNE NALIAKA MAKOKHA

Par Kenneth Juror

            Elle était une dame très heureuse tout le temps comme elle s’est décrite sur facebook ; une dame simple, pétulante et sociale. Nous nous sommes rencontrés à la l’Alliance Française d’Eldoret où je travaillais, puis nous sommes devenus des amis. Je lui ai adhéré et pas à pas elle a commencé ses études avec Lisa Kamonya et des autres étudiants. 

Car j’étais le patron du Club de français, elle aimait chanter et danser surtout la salsa. Je suis fier d’elle parce qu’à chaque instant que j’entends la chanson Collé Collé par La Compagnie Créole sa voix est toute claire dans ma tête, comment elle bougeait ne m’échappe jamais. Elle a chanté jusqu’à la demi-finale du « Concours de la musique » de l’an 2009.  

https://www.youtube.com/watch?v=k2TVM7cpEfI 

Pendant cette période du concours son nom a changé de Vivianne pour celui de Collé Collé. Beaucoup d’autres étudiants la connaissaient par le surnom Collé Collé plus que Vivianne parce que sa maîtrise de chanter était excellente.   

   

Ses études…

Elle n’avait jamais peur à s’exprimer en français comme monsieur Paul Wambete m’a dit « Vivianne avait une passion inexplicable de français » elle a tellement travaillé dur à ses études. Elle a fait ses études jusqu'au niveau 5, un niveau de l’autonomie linguistique, discursive et culturelle ; en effet elle a dû voyager en France le mois de septembre (mois prochain) pour les services au-pair avant de son décès. Elle avait déjà gagné le visa pour partir en France alors c’était seulement le billet d’avion qu’elle devait payer.

Aller en France était son rêve.

            Petit à petit l’oiseau fait son nid ; Vivianne enseignait le français à l’école d’El-View à Eldoret malgré son niveau. Elle était au deuxième niveau à cette époque là, elle était forte et uniquement fier de la langue française. Sa parole était claire et tout le temps elle parlait à la haute voix. Elle était aussi une bonne animatrice.

            Vivianne avait des différent défis surtout la compréhension de la vie, je suis croisé avec elle deux fois quand j’ai essayé de lui conseiller ; cependant il n’y a pas de route sans courbe.   

            Nous sommes allés à Musikoma, comté de Bungoma avec Richard Arina l’administrateur de l’Alliance Française d’Eldoret, Claudine Otwack, Paul Wambete, Michel Mutua, Brenda Ng’omo, Kelvin Obwoga, Dennis Werunga, Michael Sikowo, Lisa Kamonya, Timothy Ombati et Leah Odera pour les funérailles.

Avant de partir de chez elle, nous avons trouvé une opportunité rare de parler avec sa mère, chacun de nous lui a parlé. Dès que je lui ai approché pour les salutations elle m’a dit qu’elle se souvenait de moi « Je vous connais et je ne peux pas vous oublier, » la mère de Vivianne s’est confiée à moi.  

Collé Collé va franchement me manquer, néanmoins, elle vit parmi nous et sa mémoire est bien collé dans nos cœurs.

Les informations ajoutées par Richard Arina